Objective To explore the predictive effect of Glasgow Coma Scale (GCS) score on healthcare-associa-ted infection(HAI) in stroke patients undergoing surgery, and provide scientific basis for health care worker to take effective preventive measures. Methods Stroke patients who underwent surgery in the neurosurgery ward of a tertiary first-class teaching hospital from January 1, 2016 to December 31, 2018 were conducted prospective targeted surveillance, a self-designed questionnaire was used to collect patients' demographic and clinical data, clinical diffe-rences among patients were compared; accuracy of GCS in predicting HAI was tested by receiver operating characte-ristic curve (ROC curve). Results A total of 816 stroke patients were enrolled in study, 213 (26.10%) of whom had HAI, with the decrease of GCS score, HAI rate of patients showed an upward trend; pulmonary infection and surgical site infection were the most common in patients with GCS score>9, and pulmonary infection and multi-site infection were most common in patients with GCS score of 3-8. ROC curve analysis showed that area under curve of GCS score of stroke HAI, pulmonary infection, urinary tract infection, surgical site infection, and blood stream infection were 0.747 (95% CI:0.707-0.786), 0.799 (95% CI:0.759-0.838), 0.789 (95% CI:0.722-0.856), 0.565 (95% CI:0.492-0.638), and 0.730 (95% CI:0.509-0.952) respectively, with significant differences (all P<0.05). Conclusion GCS score of stroke patients has a significant predictive effect on HAI, for high-risk patients with low GCS score, effective infection prevention measures should be taken to reduce the incidence of infection.